Cholera Response and Prevention Activities

Directorate General of Health –Duhok

In response to the news of cholera cases in Kirkuk and Suleimanyiah Governorate, DGOH-Duhok take the following action:

·         On 27 September 2012: Directors of Preventive health Directorate and Central Public health Laboratory were met along with head of CDC department at DOH and immediate action were taken to intensify active Acute Watery Diarrhoea  surveillance and V.C sample taking and testing.

·         On 29 September 2012: DGOH-Duhok high committee for Cholera Response and Prevention hold its 1^st meeting chaired by Dr. Nezar Ismet Director General of Health-Duhok and following action taken:

o   Activate the high committee for cholera control at the Governorate level headed by HE Governor of Duhok.

o   Activate cholera committees at the districts and hospitals  

o   Increase direct daily coordination and cooperation with concerned Directorate (Water, Rural water, Environment, Municipality, Municipalities and Tourism).

o   Daily Operation room meeting at DG office to follow-up the situation     

o   Special attention to be made for Domiz camp

o   Intensify active Acute Watery Diarrhoea  surveillance and V.C sample taking and testing at all districts

o   Lists of required LAB reagent and materials, medicines and medical supplies were prepared for urgent procurement

o   Print and distribute standard case definition and management algorithm

o   Start wide public awareness campaign focusing on personal hygiene practices (safe water, food and clean hand).

·         On 30 September 2012: Meeting held with all Directorate of Health at the Districts and health sectors to revitalize their work and the following action taken:

o   Activate cholera committee at district headed by district Mayor

o   Brief all physician and medical staff about the current outbreak, standard case definition and management algorithm and precaution to be taken with the procedure for V.C. sample collection

o   All cases of AWD to be fully investigated and stool sample taken for VC testing

o   Daily reporting of diarrhoea cases and admission at all the hospitals

o   Lists of required LAB reagent and materials, medicines and medical supplies were prepared for urgent procurement

o   Print and distribute standard case definition and management algorithm

o   Start wide public awareness campaign through local media channels at the district focusing on personal hygiene practices (safe water, food and clean hand).

·         Following the meeting, health inspection team at all the districts started their work and large scale campaign started to raise public awareness on cholera prevention

·         Meeting were organized at all the districts with physicians and medical staff to orient them about cholera prevention, case definition and management 

·         On 2^nd October 2012: A special meeting was hold at PHD to discuss Domiz camp situation with UNICEF, UNHCR and MSF. In the meeting it was agreed on the following:

o   Surveillance: strengthen diarrhoea surveillance at the health centre including stool sample collection with community based surveillance activity using local educated volunteers with medical teaching/learning background. UNICEF will support the training and work of those community surveillance teams.

o   Health information: strengthen data collection especially on diarrhoea cases with daily reporting to establish early alarming mechanism based on standard WHO forms. Also to intensify rumours investigation and verification by all means.

o   Health inspection: all open food handling shops will be closed and instructed to open proper shop in line with standard regulations.

o   Case management of diarrhoea cases: enhance the work of the ORT unit at the clinic and with MSF support to keep it functioning till 10 pm. All cases of diarrhoea to be treated as per the standard protocol. The current stabilization room for cases that need I.V fluid.

o   Water chlorination: further discuss this issue with DDM and Rural Water department to find a practical mechanism to control the quantity and quality of water distribution by tankers.

o   Health education/promotion: enhance the work of local volunteers with focus on local hygienic practices specially hand washing and water storing/using.

o   Emergency supplies: to be ready for any emergency situation in case of any cholera cases detected

·         On 3^rd October 2013: two meeting were organized:

o   Meeting with Directors of Directorate of Water, Rural water, environment and Tourism to enhance coordination. In the meeting it was agreed to

§  increase the rate of water chlorination to 2% in all areas;

§  immediate fixing of all water leakages

§  enhance water quality monitoring and follow-up

o   Follow-up meeting was done with all districts and hospital managers to review the work done.

·         6^th Oct 2012: special measures were taken for the mass gathering of Yezidi in Lalesh temple